Individual
MRS. JENNIFER CONRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17415
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17415
MARYLAND STATE BOARD OF PHYSICAL THERAPY EXAMINERS
MD
Enumeration date
08/10/2022
Last updated
08/10/2022
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